The Role of Internet Engagement in the Health-Knowledge Gap

Abstract

The current research posits that education leads to differential levels of Internet engagement, which moderate the association between Internet use for health information and general health knowledge. Using a nationally representative survey that covers adults between the ages of 40 and 70 in the United States, it is found that education is positively related to Internet engagement. Also, Internet use has stronger associations with health knowledge for people exhibiting high Internet engagement than for people exhibiting low Internet engagement. The implications of these findings for research on both Internet use and knowledge gaps are discussed.

Ethnicity, digital divides and uses of the Internet for health information

“…In a cross-sectional study of women, Bowen et al (2003, p. 940) found that health-related Internet use was predicted by level of mental health, level of general health perceptions, older age and higher income; they conclude that perceived lack of usefulness of the Internet and lack of familiarity with the technology are ''equally important reasons as financial cost for not adopting the Internet.'' Similarly, Lee (2009) found that education is positively related to Internet engagement, as Internet use was more strongly related with health knowledge for individuals exhibiting higher levels of internet engagement.…”

“…Research (e.g., Chakraborty & Bosman, 2005;Ginossar & Nelson, 2010;Hargittai, 2009;Lee, 2009;NTIA, 2010;Pew, 2012;Rice & Katz, 2003;Vigdor & Ladd, 2010) suggests that home Personal Computer (PC) ownership and Internet access are two key challenges defining the digital divide. To the extent that online health applications can enhance preventative healthcare-and even supplement costlier in-person treatment interventions-wider diffusion of online health affordances could help curtail skyrocketing medical costs (e.g., Han et al, 2009).…”

“…Dupagne and Salwen (2005) emphasize the critical public policy debate driving this issue, one defined in terms of disparities in internet access among different social groups. Representative concerns might reflect, for instance, uncertainties among novice users about how to get started on the Internet, discomfort with the technology, and hesitancy to adopt due to a belief that computers are too complicated (e.g., Bowen et al, 2003;Dobransky & Hargittai, 2012;Hargittai, 2009;Lee, 2009;Murero & Rice, 2006;Rice, 2006).…”

“…Similarly, Kalichman et al (2006) demonstrated that use of the Internet to search for health-related information was associated with self-efficacy for information-seeking, problem-focused coping and greater social support. Given the importance of these psychosocial and technology adoption variables in online health engagement (e.g., Lee, 2008Lee, , 2009Rains, 2008), it is useful to explore how they are shaped by underlying divides in technology adoption.…”

“…Self-efficacy Pajares (2002) provides a review of self efficacy in the context of social cognitive theory, which Lin (2003) casts as a key user-level variable in her Integrated Technology Adoption (ITAP) model. Self-efficacy can be viewed as a form of self-evaluation that influences an individual's decisions about which behaviors to engage in (e.g., Bandura, 1994Bandura, , 1997Lee, 2009), how much effort to put into said behaviors and the demonstration of persistence in mastering a behavior. Bandura (2002) maintains that one's perceived self-efficacy will influence their motivation, ability, and endurance for behavioral change.…”